The potential role of immune alteration in the cancer–COVID19 equation—a prospective longitudinal study

Tal Goshen-Lago, Moran Szwarcwort-Cohen, Madeleine Benguigui, Ronit Almog, Ilit Turgeman, Nelly Zaltzman, Michael Halberthal, Yuval Shaked, Irit Ben-Aharon

Research output: Contribution to journalArticlepeer-review


Background: The risk of cancer patients to develop COVID19 infection is unclear. We aimed to prospectively study cancer patients and oncology healthcare workers for COVID19 serology. In IgG+ cases, immune profile was determined to portray the pattern of immune response to SARS-CoV2. Methods: Cancer patients on active treatment and healthcare workers were enrolled. During the study period (3/2020–6/2020), demographic data and blood were collected at three time points. Expression of IgG, IgM, and IgA were assessed. In SARS-CoV-2 IgG+ cases and matched negative cases, we performed mass cytometry time of flight (CyTOF) analysis on the basis of the expression of surface markers. Results: The study included 164 cancer patients on active intravenous treatment and 107 healthcare workers at the cancer center. No symptomatic cases were reported during the study period. Serology analysis revealed four IgG+ patients (2.4%) and two IgG+ healthcare workers (1.9%)—all were asymptomatic. CyTOF analysis demonstrated substantial reduction in myeloid cells in healthcare workers who were SARS-CoV-2 IgG+ compared to those who were SARS-CoV-2 IgG-, whereas in cancer patients, the reduction was relatively milder (≈50% reduction in SARS-CoV-2 IgG+ cancer patients compared with ≈90% reduction in SARS-CoV-2 IgG+ workers). Conclusion: Our results indicate a similar rate of asymptomatic COVID19 infection in cancer patients and healthcare workers in a longitudinal study throughout the pandemic time. Due to differential immune cell profiles of cancer patients who are treated with immunomodulatory agents, the host response to the SARS-COV2 may play a role in COVID19 course and representation. The immunological perspective of cancer treatments on the risk for COVID19 infection should be further explored.

Original languageEnglish
Article number2421
Pages (from-to)1-11
Number of pages11
Issue number9
StatePublished - Sep 2020
Externally publishedYes

Bibliographical note

Funding Information:
Author Contributions: Y.S., T.G.-L., and R.A. conceived the study, were responsible for the study design, and supervised the entire study. I.B.-A. and Y.S. obtained the financial support. T.G.-L. and I.T. recruited participants. M.S.-C., M.B., and N.Z. performed the experiments. I.B.-A., T.G.-L., and Y.S. drafted the paper. M.H., R.A., Y.S., and I.B.-A. reviewed the analysis. All authors contributed to data interpretation, manuscript writing, and review of the manuscript. All authors agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All authors have read and agreed to the published version of the manuscript.

Funding Information:
This research was funded by the Israel Cancer Research Fund?grant number 16-1276-CRCDA given to I.B.-A. This work was also supported by a grant from the European Research Council (no. 771112) given to Y.S.

Publisher Copyright:
© 2020 by the authors. Licensee MDPI, Basel, Switzerland.


  • COVID19
  • Cancer
  • Serology

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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